How OBGYN Practices Can Prepare for the 2027 Maternity Billing Changes

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The 2027 maternity billing changes will significantly alter how OBGYN practices report maternity care. Beginning January 1, 2027 , the CPT maternity care structure will move away from the traditional global model toward more detailed reporting across four phases: antepartum care, labor management, delivery, and postpartum care . The American Medical Association (AMA) has confirmed that 17 existing codes will be deleted, 12 new codes will be added, and six codes will be revised. For OBGYN practices, this is not simply a coding update. It can affect documentation, EHR workflows, charge capture, claims submission, payer contracts, reimbursement, AR, and denial management. Practices that begin preparing now will have more time to test their systems, train staff, review payer requirements, and identify potential revenue risks. For a broader explanation of the upcoming changes, see What Is the 2027 Maternity Billing Change and How Should OBGYN Practices Prepare? . Understand What Is Chan...
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The Struggle of Primary Care Physicians with Dynamic Medical Billing Rules

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Medical Billing a Challenge for Struggling Primary Care Practices

Medical billing is a complex process and it’s always been a reason for the struggle of primary care physicians. In addition, their practice is often overwhelmed with constantly changing information, including protocols and billing codes which makes the situation more challenging.

When the covid-19 pandemic strains the U.S. healthcare system, primary care physicians were working to educate their patients, employ safety protocols, and handle large volumes of calls. This large volume of calls is creating administrative hurdles and operational challenges. Hence in response, many primary care practices are making changes to their medical billing processes to accommodate new patient needs.

The recent release of the Medicare physician fee schedule final rule from the Centers for Medicare & Medicaid Services (CMS) contains new hope for struggling primary care physicians and you will get to know about it in the following brief.

Add-on Code G2211

The CMS feels the need to compensate physicians and other qualified healthcare professionals for the inherent complexity of primary care and other office visits hence CMS is moving forward with add-on code G2211.

You may separately list this add-on code in addition to office/outpatient (E/M) visits for new or established patients (i.e. codes 99202-99215). Also, you can use this code even when the E/M visit is done via telehealth as this code is permanently added to the Medicare telehealth list by CMS. One important point you need to consider here is the code’s Medicare payment allowance will be approximately $15.88, but will vary geographically.

To know more about the struggle of primary care physicians with dynamic billing rules and examples that can help you to understand, click here: https://bit.ly/3ruoVyY Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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